Post-extraction bleeding in patients on direct oral anticoagulants.

Objectives: This study aimed to evaluate the association between use of direct oral anticoagulants (DOACs) and post-extraction bleeding and to quantify bleeding risk in patients receiving DOACs.

Materials And Methods: The study included 293 patients who were taking DOACs and underwent tooth extraction (414 teeth). The patients were divided into those who had the extraction while taking DOACs and those who discontinued DOACs before the extraction.

Changes in facial width according to the ostectomy level of the proximal bone segment in intraoral vertical ramus osteotomy for mandibular prognathism.

Background: This study aimed to investigate the changes in facial width according to the ostectomy level of the proximal segment after orthognathic surgery using intraoral vertical ramus osteotomy (IVRO) in patients with mandibular prognathism.

Methods: The participants included 32 individuals who were diagnosed with class III malocclusion prior to surgery. All participants underwent orthognathic surgery using either version of IVRO.

Maxillary sinus haziness and facial swelling following suction drainage in the maxilla after orthognathic surgery.

Background: We investigated the efficacy of a maxillary Jackson-Pratt (J-P) suction drain for preventing maxillary sinus hematoma and facial swelling after maxillary Le Fort I osteotomy (LF1).

Methods: We retrospectively evaluated 66 patients who underwent LF1 at a single institution. Of these, 41 had a J-P suction tube inserted in the mandible and maxilla (maxillary insertion), and 25 had a J-P drain inserted in the mandible only (no maxillary insertion).

Effect of warfarin discontinuation on the incidence of postoperative bleeding in tooth extraction.

Objectives: The number of patients undergoing oral anticoagulant therapy for cardiovascular and cerebrovascular disease is increasing. However, the risk of bleeding after tooth extraction in patients receiving warfarin is unclear. Here, we assess the risk of bleeding after tooth extraction in patients on warfarin.

The effect of bisphosphonate discontinuation on the incidence of postoperative medication-related osteonecrosis of the jaw after tooth extraction.

Objectives: The discontinuation of bisphosphonate (BP) treatment before tooth extraction may induce medication-related osteonecrosis of the jaw (MRONJ). Whether the long-term discontinuation of BP treatment before tooth extraction affects the risk of developing MRONJ after tooth extraction or whether extended drug holidays induce systemic side effects remains unclear. The present study assessed the incidence of MRONJ among patients who underwent tooth extraction and did not discontinue BP therapy prior to the procedure.

Antibiotic sensitivity and resistance of bacteria from odontogenic maxillofacial abscesses.

Objectives: This study investigated the types and antibiotic sensitivity of bacteria in odontogenic abscesses.

Materials And Methods: Pus specimens from 1,772 patients were collected from affected areas during incision and drainage, and bacterial cultures and antibiotic sensitivity tests were performed. The number of antibiotic-resistant bacteria was analyzed relative to the total number of bacteria that were tested for antibiotic susceptibility.

Surgical treatment of stage 2 medication-related osteonecrosis of the jaw compared to osteomyelitis.

Objective: To compare the characteristics and outcomes of patients who underwent surgical treatment for stage 2 medication-related osteonecrosis of the jaw (MRONJ) versus osteomyelitis.

Methods: This retrospective study compared the following variables in 73 patients with stage 2 MRONJ versus 89 patients with osteomyelitis: impaired wound healing after surgery, sex, age, the presence of actinomycosis, location of the jaw lesion, and involvement of the inferior alveolar nerve (IAN).

Results: There were significant differences between the groups in age, sex, rates of impaired wound healing, actinomycosis, and the location (anterior/posterior) of the lesion.

Accuracy of 3-Dimensional Virtual Surgical Simulation Combined With Digital Teeth Alignment: A Pilot Study.

Purpose: To evaluate the accuracy of virtual surgical simulation combined with digital teeth alignment and the applicability of this technique to the diagnosis and establishment of a 3-dimensional (3D) visualized treatment objective for orthognathic surgery by comparing virtual simulation images with actual post-treatment images.

Materials And Methods: This retrospective study included patients who underwent computed tomography (CT) before and after treatment. The 3D digital images were constructed from the initial CT images and dental cast scan data, and virtual surgical simulation combined with digital teeth alignment was performed.

Validation of a fibula graft cutting guide for mandibular reconstruction: experiment with rapid prototyping mandible model.

Objective: We examined whether cutting a fibula graft with a surgical guide template, prepared with computer-aided design/computer-aided manufacturing (CAD/CAM), would improve the precision and accuracy of mandibular reconstruction.

Methods: Thirty mandibular rapid prototype (RP) models were allocated to experimental (N = 15) and control (N = 15) groups. Thirty identical fibular RP models were assigned randomly, 15 to each group.

Novel three-dimensional position analysis of the mandibular foramen in patients with skeletal class III mandibular prognathism.

Purpose: To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion.

Materials And Methods: Computed tomography (CT) images were collected from 85 patients. The vertical lengths of each anatomic point from the five horizontal planes passing through the MnF were measured at the coronoid process, sigmoid notch, condyle, and the gonion.

Single-tooth dento-osseous osteotomy with a computer-aided design/computer-aided manufacturing surgical guide.

This clinical note introduces a method to assist surgeons in performing single-tooth dento-osseous osteotomy. For use in this method, a surgical guide was manufactured using computer-aided design/computer-aided manufacturing technology and was based on preoperative surgical simulation data. This method was highly conducive to successful single-tooth dento-osseous segmental osteotomy.

The effect of orthognathic surgery on the lip lines while smiling in skeletal class III patients with facial asymmetry.

Background: The aim of this study was to examine the relationship between improvements in lip asymmetry at rest and while smiling after orthognathic surgery in patients with skeletal class III malocclusion.

Methods: This study included 21 patients with skeletal class III malocclusion and facial asymmetry. We used preoperative and postoperative CT data and photographs to measure the vertical distance of the lips when smiling.

Anterior tympanic plate fracture following extraction of the lower molar.

The present case report describes an external auditory canal injury following extraction of the lower molar. The external auditory canal was torn in the same fashion that occurs in an anterior tympanic plate fracture. This case demonstrates one of the rare complications associated with dental extractions.

Precision of fibula positioning guide in mandibular reconstruction with a fibula graft.

Background: This study examined the usefulness of the fibula positioning guide for boosting the accuracy of mandible reconstructions.

Methods: Thirty mandibular rapid prototype (RP) models were allocated to experimental (N = 15) and control (N = 15) groups. For reference, we prepared a reconstructed mandibular RP model with a three-dimensional printer, based on surgical simulation.

Genioplasty using a simple CAD/CAM (computer-aided design and computer-aided manufacturing) surgical guide.

Background: The present study introduces the design and fabrication of a simple surgical guide with which to perform genioplasty.

Methods: A three-dimensional reconstruction of the patient's cranio-maxilla region was built, with a dentofacial skeletal model, then derived from CT DICOM data. A surgical simulation was performed on the maxilla and mandible, using three-dimensional cephalometry.

Precision of a CAD/CAM-engineered surgical template based on a facebow for orthognathic surgery: an experiment with a rapid prototyping maxillary model.

Objective: We examined the precision of a computer-aided design/computer-aided manufacturing-engineered, manufactured, facebow-based surgical guide template (facebow wafer) by comparing it with a bite splint-type orthognathic computer-aided design/computer-aided manufacturing-engineered surgical guide template (bite wafer).

Study Design: We used 24 rapid prototyping (RP) models of the craniofacial skeleton with maxillary deformities. Twelve RP models each were used for the facebow wafer group and the bite wafer group (experimental group).

Surgery-first approach using a three-dimensional virtual setup and surgical simulation for skeletal Class III correction.

A 19-year-old woman presented to our dental clinic with anterior crossbite and mandibular prognathism. She had a concave profile, long face, and Angle Class III molar relationship. She showed disharmony in the crowding of the maxillomandibular dentition and midline deviation.

Accuracy assessment of image-based surface meshing for volumetric computed tomography images in the craniofacial region.

Background: Three-dimensional printing and computer-assisted surgery demand a high-precision three-dimensional mesh model created from computed tomography (CT) imaging data using an image-based meshing algorithm. We aimed to evaluate the three-dimensional geometric accuracy of surface meshes produced from CT images with commercially available software packages.

Methods: The CT images were acquired for 3 human dry skulls and 10 manufactured plastic skulls.

Modification of planned postoperative occlusion in orthognathic surgery, based on computer-aided design/computer-aided manufacturing-engineered preoperative surgical simulation.

In orthognathic surgery, it is important to have a planned postoperative occlusion. A 3-dimensional preoperative simulation, based on 3-dimensional optically scanned occlusion data, can predict how the planned postoperative occlusion will affect the maxilla-mandibular relationship that results from orthognathic surgery. In this study we modified the planned postoperative occlusion, based on computer-aided design/computer-aided manufacturing-engineered preoperative surgical simulations.

Verification of the usability of a navigation method in dental implant surgery: in vitro comparison with the stereolithographic surgical guide template method.

Objective: This study investigates the usefulness of a navigation method using a reference frame directly fixed to the mandible compared to the stereolithographic (STL) surgical guide template method in dental implant surgery.

Materials And Methods: Twenty rapid prototyping (RP) mandibular models were divided into two groups. Simulation surgery was performed using SimPlant software for both groups.

Validation of mandibular genioplasty using a stereolithographic surgical guide: in vitro comparison with a manual measurement method based on preoperative surgical simulation.

Purpose: Stereolithographic guidance, increasingly used in orthognathic surgery, has not been completely verified for genioplasty. This study compared the accuracy of manual measurement with that of a stereolithographic guide in vitro.

Materials And Methods: Thirty rapid prototype (RP) mandibular models (15 pairs) were included in the experimental (stereolithographic) and control (manual) groups (15 each).

Unilateral intraoral vertical ramus osteotomy based on preoperative three-dimensional simulation surgery in a patient with facial asymmetry.

Preoperative surgical simulation in orthognathic surgery has progressed in recent years; the movement of the mandible can be anticipated through three-dimensional (3D) simulation surgery before the actual procedure. In this case report, the mandible was moved to the intended postoperative occlusion through preoperative surgical 3D simulation. Right-side condylar movement change was very slight in the surgical simulation, suggesting the possibility of mandibular surgery that included only left-side ramal osteotomy.

Use of the surface-based registration function of computer-aided design/computer-aided manufacturing software in medical simulation software for three-dimensional simulation of orthognathic surgery.

Three-dimensional (3D) computed tomography image models are helpful in reproducing the maxillofacial area; however, they do not necessarily provide an accurate representation of dental occlusion and the state of the teeth. Recent efforts have focused on improvement of dental imaging by replacement of computed tomography with other detailed digital images. Unfortunately, despite the advantages of medical simulation software in dentofacial analysis, diagnosis, and surgical simulation, it lacks adequate registration tools.